Lean Six Sigma: A new approach to the management of patients undergoing prosthetic hip replacement surgery

Giovanni Improta, Giovanni Balato, Maria Romano, Francesco Carpentieri, Paolo Bifulco, Mario Alessandro Russo, Donato Rosa, Maria Triassi, Mario Cesarelli

Research output: Contribution to journalArticle

Abstract

Rationale, aims and objectives In 2012, health care spending in Italy reached €114.5 billion, accounting for 7.2% of the Gross Domestic Product (GDP) and 14.2% of total public spending. Therefore, reducing waste in health facilities could generate substantial cost savings. The objective of this study is to show that Lean Six Sigma represents an appropriate methodology for the development of a clinical pathway which allows to improve quality and to reduce costs in prosthetic hip replacement surgery. Methods The methodology used for the development of a new clinical pathway was Lean Six Sigma. Problem solving in Lean Six Sigma is the DMAIC (Define, Measure, Analyse, Improve, Control) roadmap, characterized by five operational phases which make possible to reach fixed goals through a rigorous process of defining, measuring, analysing, improving and controlling business problems. Results The following project indicated several variables influencing the inappropriate prolongation of the length of stay for inpatient treatment and corrective actions were performed to improve the effectiveness and efficiency of the process of care. The average length of stay was reduced from 18.9 to 10.6 days (-44%). Conclusion This article shows there is no trade-off between quality and costs: Lean Six Sigma improves quality and, at the same time, reduces costs.

Original languageEnglish
Pages (from-to)662-672
Number of pages11
JournalJournal of Evaluation in Clinical Practice
Volume21
Issue number4
DOIs
Publication statusPublished - Aug 1 2015

Fingerprint

Total Quality Management
Hip
Critical Pathways
Costs and Cost Analysis
Length of Stay
Gross Domestic Product
Cost Savings
Health Facilities
Italy
Inpatients
Delivery of Health Care
Efficiency

Keywords

  • efficiency of care
  • health care management
  • health economics
  • health services research
  • Lean Six Sigma
  • public health
  • reducing length of stay

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health Policy

Cite this

Lean Six Sigma : A new approach to the management of patients undergoing prosthetic hip replacement surgery. / Improta, Giovanni; Balato, Giovanni; Romano, Maria; Carpentieri, Francesco; Bifulco, Paolo; Alessandro Russo, Mario; Rosa, Donato; Triassi, Maria; Cesarelli, Mario.

In: Journal of Evaluation in Clinical Practice, Vol. 21, No. 4, 01.08.2015, p. 662-672.

Research output: Contribution to journalArticle

Improta, G, Balato, G, Romano, M, Carpentieri, F, Bifulco, P, Alessandro Russo, M, Rosa, D, Triassi, M & Cesarelli, M 2015, 'Lean Six Sigma: A new approach to the management of patients undergoing prosthetic hip replacement surgery', Journal of Evaluation in Clinical Practice, vol. 21, no. 4, pp. 662-672. https://doi.org/10.1111/jep.12361
Improta, Giovanni ; Balato, Giovanni ; Romano, Maria ; Carpentieri, Francesco ; Bifulco, Paolo ; Alessandro Russo, Mario ; Rosa, Donato ; Triassi, Maria ; Cesarelli, Mario. / Lean Six Sigma : A new approach to the management of patients undergoing prosthetic hip replacement surgery. In: Journal of Evaluation in Clinical Practice. 2015 ; Vol. 21, No. 4. pp. 662-672.
@article{ccd6d2fd0716476685410ee82f2d5692,
title = "Lean Six Sigma: A new approach to the management of patients undergoing prosthetic hip replacement surgery",
abstract = "Rationale, aims and objectives In 2012, health care spending in Italy reached €114.5 billion, accounting for 7.2{\%} of the Gross Domestic Product (GDP) and 14.2{\%} of total public spending. Therefore, reducing waste in health facilities could generate substantial cost savings. The objective of this study is to show that Lean Six Sigma represents an appropriate methodology for the development of a clinical pathway which allows to improve quality and to reduce costs in prosthetic hip replacement surgery. Methods The methodology used for the development of a new clinical pathway was Lean Six Sigma. Problem solving in Lean Six Sigma is the DMAIC (Define, Measure, Analyse, Improve, Control) roadmap, characterized by five operational phases which make possible to reach fixed goals through a rigorous process of defining, measuring, analysing, improving and controlling business problems. Results The following project indicated several variables influencing the inappropriate prolongation of the length of stay for inpatient treatment and corrective actions were performed to improve the effectiveness and efficiency of the process of care. The average length of stay was reduced from 18.9 to 10.6 days (-44{\%}). Conclusion This article shows there is no trade-off between quality and costs: Lean Six Sigma improves quality and, at the same time, reduces costs.",
keywords = "efficiency of care, health care management, health economics, health services research, Lean Six Sigma, public health, reducing length of stay",
author = "Giovanni Improta and Giovanni Balato and Maria Romano and Francesco Carpentieri and Paolo Bifulco and {Alessandro Russo}, Mario and Donato Rosa and Maria Triassi and Mario Cesarelli",
year = "2015",
month = "8",
day = "1",
doi = "10.1111/jep.12361",
language = "English",
volume = "21",
pages = "662--672",
journal = "Journal of Evaluation in Clinical Practice",
issn = "1356-1294",
publisher = "Wiley-Blackwell",
number = "4",

}

TY - JOUR

T1 - Lean Six Sigma

T2 - A new approach to the management of patients undergoing prosthetic hip replacement surgery

AU - Improta, Giovanni

AU - Balato, Giovanni

AU - Romano, Maria

AU - Carpentieri, Francesco

AU - Bifulco, Paolo

AU - Alessandro Russo, Mario

AU - Rosa, Donato

AU - Triassi, Maria

AU - Cesarelli, Mario

PY - 2015/8/1

Y1 - 2015/8/1

N2 - Rationale, aims and objectives In 2012, health care spending in Italy reached €114.5 billion, accounting for 7.2% of the Gross Domestic Product (GDP) and 14.2% of total public spending. Therefore, reducing waste in health facilities could generate substantial cost savings. The objective of this study is to show that Lean Six Sigma represents an appropriate methodology for the development of a clinical pathway which allows to improve quality and to reduce costs in prosthetic hip replacement surgery. Methods The methodology used for the development of a new clinical pathway was Lean Six Sigma. Problem solving in Lean Six Sigma is the DMAIC (Define, Measure, Analyse, Improve, Control) roadmap, characterized by five operational phases which make possible to reach fixed goals through a rigorous process of defining, measuring, analysing, improving and controlling business problems. Results The following project indicated several variables influencing the inappropriate prolongation of the length of stay for inpatient treatment and corrective actions were performed to improve the effectiveness and efficiency of the process of care. The average length of stay was reduced from 18.9 to 10.6 days (-44%). Conclusion This article shows there is no trade-off between quality and costs: Lean Six Sigma improves quality and, at the same time, reduces costs.

AB - Rationale, aims and objectives In 2012, health care spending in Italy reached €114.5 billion, accounting for 7.2% of the Gross Domestic Product (GDP) and 14.2% of total public spending. Therefore, reducing waste in health facilities could generate substantial cost savings. The objective of this study is to show that Lean Six Sigma represents an appropriate methodology for the development of a clinical pathway which allows to improve quality and to reduce costs in prosthetic hip replacement surgery. Methods The methodology used for the development of a new clinical pathway was Lean Six Sigma. Problem solving in Lean Six Sigma is the DMAIC (Define, Measure, Analyse, Improve, Control) roadmap, characterized by five operational phases which make possible to reach fixed goals through a rigorous process of defining, measuring, analysing, improving and controlling business problems. Results The following project indicated several variables influencing the inappropriate prolongation of the length of stay for inpatient treatment and corrective actions were performed to improve the effectiveness and efficiency of the process of care. The average length of stay was reduced from 18.9 to 10.6 days (-44%). Conclusion This article shows there is no trade-off between quality and costs: Lean Six Sigma improves quality and, at the same time, reduces costs.

KW - efficiency of care

KW - health care management

KW - health economics

KW - health services research

KW - Lean Six Sigma

KW - public health

KW - reducing length of stay

UR - http://www.scopus.com/inward/record.url?scp=84938214567&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84938214567&partnerID=8YFLogxK

U2 - 10.1111/jep.12361

DO - 10.1111/jep.12361

M3 - Article

C2 - 25958776

AN - SCOPUS:84938214567

VL - 21

SP - 662

EP - 672

JO - Journal of Evaluation in Clinical Practice

JF - Journal of Evaluation in Clinical Practice

SN - 1356-1294

IS - 4

ER -